Ex vivo comparison of pin placement with patient-specific drill guides or freehand technique in canine cadaveric spines.

OBJECTIVE: To compare vertebral implant placement in the canine thoracolumbar spine between 3D-printed patient-specific drill guides (3DPG) and the conventional freehand technique (FH). STUDY DESIGN: Ex vivo study. ANIMALS: Cadaveric canine spines (n = 24). METHODS: Implant trajectories were established for the left and right sides of the T10 through L6 vertebrae based on computed tomography (CT) imaging. Customized drill guides were created for each vertebra of interest. Each cadaver was randomly assigned to one of six veterinarians with varying levels of experience placing vertebral implants. Vertebrae were randomly assigned a surgical order and technique (3DPG or FH) for both sides. Postoperative CT images were acquired. A single, blinded observer assessed pin placement using a modified Zdichavsky classification. RESULTS: A total of 480 implants were placed in 240 vertebrae. Three sites were excluded from the analysis; therefore, a total of 238 implants were evaluated using the FH technique and 239 implants using 3DPG. When evaluating implant placement, 152/239 (63.6%) of 3DPG implants were considered to have an acceptable placement in comparison with 115/248 (48.32%) with FH. Overall, pin placement using 3DPG was more likely to provide acceptable pin placement (p < .001) in comparison with the FH technique for surgeons at all levels of experience. CONCLUSION: The use of 3DPG was shown to be better than the conventional freehand technique regarding acceptable placement of implants in the thoracolumbar spine of canine cadavers. CLINICAL SIGNIFICANCE: Utilizing 3DPG can be considered better than the traditional FH technique when placing implants in the canine thoracolumbar spine.

An avian Modified Glasgow Coma Scale as a prognostic indicator in raptors with head trauma.

OBJECTIVE: To develop a Modified Glasgow Coma Scale (MGCS) for use in raptors presenting with head trauma and assess the agreement of the MGCS scores between examiners with varying backgrounds, and to assess the prognostic value of the avian MGCS in raptors with head trauma. ANIMALS: 156 native raptorial species. METHODS: All raptors received an MGCS assessment within 8 hours of their presentation, between January 1, 2018, and December 31, 2019. For the first objective, the assessment was performed by a veterinary student, a wildlife veterinarian, and a board-certified or resident veterinary neurologist. Each animal received a score in 3 categories (motor activity, level of consciousness, and brain stem reflexes) and an overall score. For the second objective, the MGCS scoring was performed by the intaking clinical team member and survival after 48 hours was documented. RESULTS: Agreement between the 3 individual scores was assessed via Cronbach α and intraclass correlation. There was excellent-good agreement in all 3 assessment categories as well as the overall score. Univariate associations between survival and demographic factors were determined using the χ2 test. Overall, raptors with a total MGCS of < 10 were less likely to survive than those with a score > 12. CLINICAL RELEVANCE: An avian-specific MGCS demonstrated good-excellent agreement among raters of various backgrounds in assessing raptors with head trauma. Additionally, this study showed that an avian-specific MGCS may be correlated with the probability of survival within the first 48 hours after presentation to rehabilitation facilities in raptors with head trauma.

A smart coating with integrated physical antimicrobial and strain-mapping functionalities for orthopedic implants.

The prevalence of orthopedic implants is increasing with an aging population. These patients are vulnerable to risks from periprosthetic infections and instrument failures. Here, we present a dual-functional smart polymer foil coating compatible with commercial orthopedic implants to address both septic and aseptic failures. Its outer surface features optimum bioinspired mechano-bactericidal nanostructures, capable of killing a wide spectrum of attached pathogens through a physical process to reduce the risk of bacterial infection, without directly releasing any chemicals or harming mammalian cells. On its inner surface in contact with the implant, an array of strain gauges with multiplexing transistors, built on single-crystalline silicon nanomembranes, is incorporated to map the strain experienced by the implant with high sensitivity and spatial resolution, providing information about bone-implant biomechanics for early diagnosis to minimize the probability of catastrophic instrument failures. Their multimodal functionalities, performance, biocompatibility, and stability are authenticated in sheep posterolateral fusion model and rodent implant infection model.

The pharmacokinetics of single oral dose extended-release topiramate and adverse effects after multi-dose administration in healthy cats.

Current treatment options for feline epilepsy are limited to medications that require administration of multiple doses per day or administration of a capsule or large tablet. Expanding the current treatment options could improve patient and owner compliance and optimize seizure control. Topiramate has been used sparingly in veterinary medicine, and limited pharmacokinetic studies have focused on immediate release formulations in dogs. If effective and safe, topiramate extended-release (XR) could broaden the current treatment options for feline epilepsy. The aims of this two-phase study were to establish single-dose pharmacokinetics for topiramate XR in cats, identify a dosing regimen that maintains steady-state plasma drug concentrations within a reference range extrapolated from human medicine (5-20 µg/mL), and evaluate the safety of topiramate XR in cats following multidose administration. Topiramate XR administered orally at 10 mg/kg once daily for 30 days was sufficient to achieve the desired concentrations in all cats. While no clinically apparent adverse effects were observed, four out of eight cats developed subclinical anemia, calling into question the safety of topiramate XR with chronic administration. Further studies are necessary to better understand the potential adverse effects and overall efficacy of topiramate XR for the treatment of feline epilepsy.

Canine brucellosis in three littermates, case report.

Three adult littermates were diagnosed with Brucella canis, two of which were diagnosed with discospondylitis. The first littermate, a 2-year-old spayed-female Labrador Retriever, was evaluated for progressive episodes of cervical pain, lethargy, reported circling to the right, and a right-sided head tilt. Magnetic resonance imaging (MRI) of the cervical spine revealed changes consistent with discospondylitis at C6-C7. MRI of the brain was unremarkable and cerebrospinal fluid analysis was declined. Brucella spp. was isolated from aerobic and Brucella blood cultures. PCR performed on the isolate identified Brucella canis and indirect fluorescent antibody (IFA) testing for Brucella canis also confirmed the species. Patient #1 was treated with doxycycline and marbofloxacin for 1 year. Clinical signs returned 2-years after diagnosis. Following the diagnosis of patient #1, a known littermate (patient #2) was tested for Brucella canis. Patient #2 was 2 years old and asymptomatic at the time of diagnosis. Aerobic and Brucella spp. cultures, PCR, and IFA were obtained and were diagnostic for Brucella canis. A 6-month course of marbofloxacin and doxycycline was implemented. The patient remained PCR positive following 4 months of treatment and repeat cultures were planned following 6 months of treatment; however, the patient was lost to follow-up. A third littermate (patient #3) was identified by the family of patient #1. Patient #3 was evaluated at 18 months of age for a 6-month history of progressive lumbosacral pain. Spinal radiographs revealed discospondylitis of the C3-C4, T12-T13, and L7-S1 vertebral endplates. Computed tomography (CT) of the lumbosacral spine was also consistent with discospondylitis at L7-S1. Brucella canis serologic testing consisting of rapid slide agglutination test, 2ME-rapid slide agglutination test, and cytoplasmic agar gel immunodiffusion was positive. Enrofloxacin was administered for 7 months and was discontinued thereafter based on radiographic evidence of healing and resolution of clinical signs. Although Brucella canis is not a rare disease in dogs, the documentation of two out of three adult littermates with associated discospondylitis is an interesting feature. In addition, this report highlights available diagnostic and treatment options, as each patient was managed differently based on clinical signs and the preference of the managing clinician.

Establishing an MRI-Based Protocol and Atlas of the Bearded Dragon (Pogona vitticeps) Brain.

The bearded dragon (Pogona vitticeps) has become a popular companion lizard, and as such, clients have increasingly come to expect the application of advanced diagnostic and therapeutic options in their care. The purpose of this study was to establish an MRI-based protocol and brain atlas to improve diagnostic capabilities in bearded dragons presenting with neurologic dysfunction. Using a high-field 3T magnet, in vivo MRI of the brain was successfully performed in seven healthy bearded dragons utilizing an injectable anesthetic protocol utilizing intravenous alfaxalone. From this, we created an atlas of the brain in three planes, identifying nine regions of interest. A total scan time of 35 min allowed for the collection of a quality diagnostic scan and all lizards recovered without complication. This study provides practitioners a neuroanatomic reference when performing brain MRI on the bearded dragon along with a concise and rapid MRI protocol.

Effectiveness of Supplementary Materials in Teaching the Veterinary Neurologic Examination.

Clinical neurology can be difficult for veterinary students to comprehend, and part of understanding the clinical aspect is performing a proper neurologic examination. In this study, first-year veterinary students in a Small Animal Physical Exam and Anatomy rotation were given supplemental learning activities to determine their effect on student procedural knowledge and motivation in performing a neurologic examination. Students were randomly assigned to one of three groups: the first watched a video of a clinician performing the neurologic examination, the second read a handout about the neurologic exam, and the third was the control group, where students were not provided any supplemental activities. At the start and end of the rotation, students participated in a survey assessing their overall procedural knowledge and motivation to learn about the neurologic exam. No notable improvement occurred in overall student knowledge from the beginning to end of the rotation, nor when using supplemental material (p > .05). However, there was a significant difference in quiz scores between the three condition groups (p < .01), suggesting the type of learning activity did influence student learning. Additionally, students in the video and reading groups showed a significant increase in motivational scores compared with those in the control group (p < .05), demonstrating supplemental learning activities do improve student motivation in learning about the neurologic examination. This study provides evidence that while supplemental materials may not immediately help veterinary students learn to perform the neurologic examination, they do have a positive impact on students' learning motivation.

Magnetic resonance imaging findings and antemortem cytologic diagnosis of intramedullary spinal cord ependymoma in a dog.

CASE DESCRIPTION: A 3-year-old 31.1-kg castrated male mixed-breed dog was evaluated because of a 1- to 2-week history of paraparesis, knuckling of the hind feet, and difficulty posturing to urinate or defecate. CLINICAL FINDINGS: The dog was paraparetic but weakly ambulatory with a kyphotic posture, a mildly decreased patellar reflex in the right pelvic limb, increased tone in both pelvic limbs, and marked hyperesthesia on paraspinal palpation of the lumbar region. The urinary bladder was enlarged and firm on palpation. Neuroanatomic findings were primarily consistent with localization to the T3-L3 spinal cord segments. Magenetic resonance imaging of the thoracolumbar spinal column revealed a discrete intramedullary spinal cord mass from the cranial aspect of L4 to the middle of L5. The mass was sampled by fine-needle aspiration, and on cytologic evaluation, the suspected diagnosis was an ependymoma. TREATMENT AND OUTCOME: Owing to poor prognosis and limited treatment options, the owner elected euthanasia. Postmortem examination of the spinal cord and histologic findings for samples of the mass supported a likely diagnosis of ependymoma. CLINICAL RELEVANCE: Ependymoma is a rare neoplasm in dogs but should be considered in young patients with evidence of a tumor in the CNS. Fine-needle aspiration of the spinal cord mass was possible in the dog of this report, and the cytologic findings provided useful diagnostic information.

Pharmacokinetics of a cytosine arabinoside subcutaneous protocol in dogs with meningoencephalomyelitis of unknown aetiology.

Cytosine arabinoside (CA) is a commonly used treatment for dogs with meningoencephalomyelitis of unknown aetiology (MUE) with various proposed protocols, many requiring 24 hours (h) of hospitalization or two visits within 24 h. This is a unidirectional study evaluating the pharmacokinetics of a CA subcutaneous (SC) protocol and a standard constant rate infusion (CRI) protocol in 8 dogs with MUE. Dogs received the CRI (200 mg/m2 IV over 24 h), followed by a SC protocol (50 mg/m2 every 2 h for 4 treatments) four weeks later. Plasma CA concentrations were measured by high-pressure liquid chromatography-tandem mass spectrometry (HPLC-MS). Median peak CA concentration for the SC protocol (3.40 µg/ml, range 1.60-9.70 µg/ml) was significantly higher than the CRI (1.09 µg/ml, range 0.77-1.67 µg/ml; p = .02). Median concentration at 1h and 8h following initiation of treatment was significantly higher for the SC protocol (CA1 2.28 µg/ml, range 0.97-2.67; CA8 1.83 µg/ml, range 0.77-2.84) compared to the CRI (CA1 0.01 µg/ml, range 0-0.45; CA8 0.74 µg/ml, range 0.67-1.11; p = .01). While the PK properties of CA when administered as a CRI has been previously investigated, this study demonstrated that CA when administered via repeated 50 mg/m2 injections every 2 h over an 8-h period, provided sustained plasma levels above its therapeutic target and for a significantly longer duration of time than did a standard CRI protocol.

Assessment of the cutaneous trunci reflex in neurologically healthy cats.

OBJECTIVES: The aim of this study was to perform the cutaneous trunci reflex (CTR) in neurologically normal cats using two different instruments and determine how body condition score (BCS), body circumference, age, sex and instrument type may affect this reflex. METHODS: Sixty-five cats without evidence of neurologic disease were prospectively enrolled. Cats were randomly assigned to have the reflex tested first using a pair of hemostatic forceps or the integrated Babinski tip of an MDF Babinski Buck Reflex Hammer. After 30 mins, the reflex was retested using the other instrument. Data collected included the reflex presence, reflex caudal border, reflex intensity (weak, moderate, strong) and reflex symmetry (unilateral or bilateral). The influence of BCS, body circumference, age and sex on these variables was statistically evaluated along with effect of the instrument used. RESULTS: The CTR was elicited bilaterally in 52 (80%) cats and unilaterally in 64 (98%) cats. In two cats, the CTR was only able to be elicited using the Buck Reflex Hammer, while in four cats, the CTR was only able to be elicited using hemostatic forceps. Body circumference, BCS, age and sex had no effect on the presence, caudal border, intensity or symmetry of the CTR, regardless of the instrument used. No difference in the bilateral presence of the CTR was noted based on the instrument used first (P = 0.53). When assessing the influence of the instrument on reflex presence, caudal border, intensity and symmetry, the hemostatic forceps elicited the reflex further caudally (P = 0.02) and usually bilaterally (P = 0.02). CONCLUSIONS AND RELEVANCE: The CTR could be elicited in the majority of cats with both instruments. However, hemostatic forceps elicited a reflex more caudally and bilaterally symmetrical than the Buck Reflex Hammer.

Comparison of creatine kinase in cerebrospinal fluid collected from the cerebellomedullary and lumbar cisterna in 10 dogs with neurologic disease.

BACKGROUND: Analysis of cerebrospinal fluid CK (CSF-CK) might be useful as a prognostic indicator in dogs with neurologic disease. Previous studies have mostly analyzed CSF-CK collected from the cerebellomedullary (CM) cisterna, but CSF collection sites could affect its levels. OBJECTIVES: This is a pilot study aimed to evaluate differences in CSF-CK concentrations when collected from the CM or lumbar cisterna in dogs presenting with neurologic disease. METHODS: Ten dogs presenting for neurologic disease underwent magnetic resonance imaging and CSF collection from both the CM and lumbar cisterna. Cerebrospinal fluid CK was analyzed within 30 minutes. RESULTS: Ten dogs were prospectively recruited. Overall, there was no statistically significant difference between CSF-CK collected from the CM or lumbar cisterna (P = .31). When evaluated by neurolocalization, CSF-CK was different between sites in dogs with thoracolumbar myelopathy (P = .024), but not in dogs with intracranial or cervical neurolocalization (P = .93). All dogs with thoracolumbar myelopathy had equivocal or higher CK levels at the lumbar collection site compared with levels at the CM collection site. CONCLUSIONS: Cerebrospinal fluid CK values differed depending on the CSF site collection, especially in dogs with thoracolumbar myelopathy. In dogs with thoracolumbar myelopathy, CSF-CK was likely to be higher when CSF was taken from the lumbar cisterna compared with the CM cisterna. Collecting CSF from the thoracolumbar site could provide better prognostic information than if collected at the CM collection site.

Dynamic MRI is reliable for evaluation of the lumbosacral spine in healthy dogs.

Magnetic resonance imaging (MRI) is commonly used to diagnose degenerative lumbosacral stenosis; however, studies show limited correlation between imaging and clinical signs. The purpose of this prospective observer agreement study was to use dynamic MRI of the lumbosacral (LS) spine of healthy dogs to determine reliable reference ranges. Twenty-two healthy large breed dogs were prospectively enrolled. MRI of the LS spine was performed in T2-weighted, T1-weighted, and T2-weighted SPACE sequences in neutral, flexed, and extended positions. Four observers performed image analyses. Measurements included LS angle, vertebral canal height and area, and LS foraminal areas. Ordinal categorical assessment of loss of fat signal in the foramina, LS compression, intervertebral disc (IVD) degeneration, spondylosis, and IVD protrusion was also performed. The majority of values were significantly larger in flexion versus neutral position, and significantly smaller in extension versus neutral position (P < .05). Subclinical compression and IVD protrusion was noted in a neutral position in 45% and 55% of dogs and in an extended position in 85% and 73% of dogs, respectively. Interobserver agreement was strong (intracluster correlation coefficient [ICC] > .5) except for the L7:LS vertebral canal area ratio (ICC ≤ .03). Intraobserver agreement was high (rho > .5) for all measurements except for the mid-L6:LS vertebral canal height ratio (rho = .38). There was poor interobserver agreement for loss of fat signal in the foramina and evidence of compression. This study provides the groundwork for future studies using dynamic MRI to evaluate dogs with signs of clinical LS disease.

Assessment of the cutaneous trunci muscle reflex in neurologically abnormal cats.

OBJECTIVES: The aim of this study was to evaluate the presence of the cutaneous trunci reflex (CTR) in a population of neurologically abnormal cats in regard to age, body condition score (BCS), sex, breed, evidence of traumatic injury, pain, known metabolic disease, mentation, neurolocalization and diagnostic classification. METHODS: A retrospective medical record review was performed to identify cats with a history of neurologic disease undergoing a complete neurologic assessment between 24 September 2012 and 20 March 2019. CTR outcome (present, absent), signalment, evidence of traumatic injury, pain, known metabolic disease, mentation, neurolocalization and diagnostic classification were recorded. RESULTS: A total of 182 cats were identified. The CTR was present in 118 cats (64.8%) and absent in 64 cats (35.2%). Statistical analysis revealed no association between CTR outcome and age, BCS, sex, breed, evidence of traumatic injury, non-spinal pain, known metabolic disease, mentation, neurolocalization or diagnostic classification. A significant association was found between spinal pain and CTR outcome (P = 0.037). CONCLUSIONS AND RELEVANCE: These findings suggest that elicitation of the CTR in the cat can be unreliable. Further prospective controlled studies are warranted to determine whether continued inclusion of the CTR in feline neurologic examinations is justified. Consideration of the reliability of the CTR is indicated, particularly in the context of fractious or anxious patients for which only a limited window for examination may be present.

Comparison of cerebellomedullary and lumbar cerebrospinal fluid analysis in dogs with neurological disease.

BACKGROUND: Cerebrospinal fluid (CSF) analysis aids in categorizing underlying disease processes in patients with neurologic disease. Convention suggests that CSF should be collected caudal to the lesion. However, little evidence exists to justify this assertion. HYPOTHESIS/OBJECTIVES: Evaluate the clinicopathologic differences between CSF collected from the cerebellomedullary (CM) and lumbar cisterns in dogs presented for evaluation of neurologic disease. ANIMALS: Fifty-one client-owned dogs undergoing magnetic resonance imaging (MRI) and CSF collection for investigation of neurologic disease. METHODS: Cerebrospinal fluid was prospectively collected from the CM and lumbar cisterns in all patients. The total protein (TP) concentration, red blood cell (RBC) count, and total nucleated cell count (TNCC) were analyzed within 30 minutes of collection. Results and cytology findings were interpreted by a single pathologist. RESULTS: Fifty-one paired samples were collected. The TNCC (P < .001), RBC (P < .001), and TP (P < .001) were different between collection sites. When grouped by neurolocalization, TP (intracranial, P < .001; cervical, P < .001; thoracolumbar, P < .001) and RBC (intracranial, P < .001; cervical, P ≤ .002; thoracolumbar, P = .006) counts were significantly different. The TNCC was significantly different in the cervical (P = .04) and thoracolumbar localizations (P = .004) but not for intracranial (P = .30) localizations. The pathologist's interpretation differed between sites in 66.7% of the cases (34/51). CONCLUSIONS: In dogs with lesions that neurolocalized to the brain or cervical spinal cord, there may be clinical benefit in collecting fluid from both the CM and lumbar cisterns. In dogs with thoracolumbar myelopathy, CSF collected from the CM cistern may not be representative of the underlying disease process.

Noise-Induced Hearing Loss in 3 Working Dogs.

Three working dogs were diagnosed with noise-induced hearing loss following exposure to loud noise. Physical and neurologic examinations in each case revealed no significant findings. Brainstem auditory evoked response (BAER) demonstrated bilateral sensorineural deafness. One dog did not regain hearing but continued working with adjusted protocols utilizing hand signals. One dog was lost to follow-up. The last dog was treated with oral Vitamin B complex (daily), Vitamin E (400 IU daily), and N-acetyl-cystine (600 mg daily) and regained hearing 2 months later, based on repeat BAER testing.

The utility of intraoperative impression smear cytology of intracranial granular cell tumors: Three cases.

Two adult male dogs (a 7-year-old shorthaired Chihuahua and 14-year-old Shih Tzu) and one adult female dog (a 9-year-old Maltese) presented for evaluation of new-onset seizure activity. Magnetic resonance imaging of the brain demonstrated a large, poorly marginated T2-weighted hyperintense, and strong contrast enhancing extra-axial mass in each case. A surgical biopsy for histopathologic evaluation was elected in all cases, and intraoperative impression smears were successfully obtained. Intraoperative cytology identified a homogenous population of round to polygonal cells with central to eccentric nuclei, coarse chromatin, and variably amphophilic to eosinophilic granular cytoplasm. Cytologic findings led to a suspected diagnosis of granular cell tumor (GCT) in all cases. Histopathologic review identified a densely cellular, unencapsulated neoplastic mass comprised of sheets of large round to polygonal cells with abundant eosinophilic cytoplasm containing numerous eosinophilic intracytoplasmic granules, confirming the diagnosis of GCT in all cases. The cases reported here are unique in that they reveal an accurate intraoperative cytologic diagnosis of a rare canine central nervous system neoplasm. Intraoperative cytology of the intracranial masses could provide clinicians with important and quick diagnostic and prognostic information; therefore, expediting decisions made intraoperatively. Further research is warranted to determine the diagnostic accuracy of intraoperative cytology for neoplasia in veterinary patients.

Clinical features and short-term outcome of presumptive intracranial complications associated with otitis media/interna: a multi-center retrospective study of 19 cats (2009-2017).

OBJECTIVES: The aim of this study was to compile an overview of the clinical features of intracranial complication of otitis media/interna (OMI) in cats managed across five veterinary referral hospitals. Of additional interest were culture results that could inform empirical antibiotic selection, as well as outcome with both medical and surgical management. METHODS: A retrospective medical record review was conducted at five veterinary referral practices to identify cats with a diagnosis of intracranial complication secondary to OMI between 2009 and 2017. Clinical features, diagnostic findings, treatment and outcome were recorded. RESULTS: At total of 19 cats were identified. Sixty-three percent had no previous history of ear infection. Otoscopic examination was normal in 47% of cases. The most common bacterial isolate was Pasteurella multocida, which was identified in 24% of cases. Outcome was successful for 83% of cats managed with ventral bulla osteotomy (VBO) and in 66% of cats managed without surgical intervention. CONCLUSIONS AND RELEVANCE: Clinical suspicion of intracranial complications of OMI should remain high in cats with central vestibular disease even if otoscopic examination is normal. Antibiotic selection should be based on a culture and sensitivity; however, initial antibiotic therapy should include broad-spectrum coverage with special consideration for P multocida. Cats with intracranial complications of OMI can have a good outcome with either surgical or medical management and prospective studies are needed to assess the role of VBO in enhancing recovery.

Effect of implementation of a surgical safety checklist on perioperative and postoperative complications at an academic institution in North America.

OBJECTIVE: To evaluate the efficacy of a surgical safety checklist (SSC) in reducing perioperative and postoperative complications. STUDY DESIGN: Before-and-after intervention study. ANIMALS: Client-owned dogs (n = 633) and cats (n = 44). METHODS: Consecutive surgeries were enrolled in the study. The "before" phase consisted of 267 surgeries performed without an SSC (SSC- ) followed by 75 SSC- surgeries in which a trained observer was in the operating room to detect possible complications. An SSC was then implemented in the operating rooms during 1 week. The "after" phase consisted of 58 surgeries in which a safety checklist (SSC+ ) and an observer were used and 277 SSC+ surgeries without an observer. Complications were prospectively recorded when witnessed by the observer, and all other perioperative complications were retrospectively recorded from veterinary records and client telephone communication. RESULTS: There were more perioperative and postoperative complications when surgeries were performed without an SSC (140/342 [40.9%; 95% CI, 35.7%-46.4%]) than there were when surgeries were performed with an SSC (98/335 [29.3%; 95% CI, 24.4%-34.4%]; P = .002). Surgical checklist use, presence of an observer, American Society of Anesthesiologists score, and anesthesia time were all independently associated with the odds of complications. CONCLUSION: Implementation of an SSC in an academic teaching hospital decreased the odds of perioperative and postoperative surgical complications. CLINICAL SIGNIFICANCE: This study supports the use of an SSC to prevent surgical complications in veterinary teaching hospitals.

Kinetic and kinematic follow-up gait analysis in Doberman Pinschers with cervical spondylomyelopathy treated medically and surgically.

BACKGROUND: The efficacy of treatment of dogs with cervical spondylomyelopathy (CSM) is commonly based on the owner's and clinician's perception of the gait, which is highly subjective and suffers from observer bias. HYPOTHESIS/OBJECTIVES: To compare selected kinetic and kinematic parameters before and after treatments and to correlate the findings of gait analysis to clinical outcome. ANIMALS: Eight Doberman Pinschers with CSM confirmed by magnetic resonsance imaging. METHODS: Patients were prospectively studied and treated with either medical management (n = 5) or surgery (n = 3). Force plate analysis and 3-D kinematic motion capture were performed at initial presentation and approximately 8 weeks later. Force plate parameters evaluated included peak vertical force (PVF). Kinematic parameters measured included number of pelvic limb strides, stifle flexion and extension, maximum and minimum thoracic limb distance, truncal sway, and thoracic limb stride duration. RESULTS: Kinematic analysis showed that deviation of the spine to the right (truncal sway) was significantly smaller (P < .001) and the degree of right stifle flexion was significantly larger (P = .029) after treatment. Force plate analysis indicated that PVF was significantly different after treatment (P = .049) and the difference of the PVF also was significantly larger (P = .027). However, no correlation was found with either method of gait analysis and clinical recovery. CONCLUSIONS AND CLINICAL IMPORTANCE: Kinetic and kinematic gait analysis were able to detect differences in dogs with CSM before and after treatment. A correlation of gait analysis to clinical improvement could not be determined.

Long-term outcome following surgical and radiation treatment of vertebral angiomatosis in a cat.

CASE DESCRIPTION A 2-year-old 5.2-kg (11.4-lb) neutered male domestic shorthair cat was referred because of a 6-week history of progressive paraparesis. CLINICAL FINDINGS Neurologic examination revealed moderate ambulatory paraparesis with marked spinal hyperesthesia at the thoracolumbar junction. The lesion was localized to the T3-L3 spinal cord segment. Clinicopathologic testing, thoracic radiography, and abdominal ultrasonography revealed no abnormalities to explain the observed clinical signs. Advanced spinal imaging with MRI revealed an extradural right-lateralized mass originating from the L2 vertebral pedicle and causing severe spinal cord compression. TREATMENT AND OUTCOME Surgical decompression was achieved by performance of a right-sided hemilaminectomy at L2. Histologic examination of biopsy samples obtained from the mass revealed an ill-defined zone of mature vascular proliferation extending through the preexisting vertebral bone, consistent with vertebral angiomatosis. After surgical recovery, adjuvant radiation therapy was initiated with a total dose of 48 Gy administered in 16 fractions of 3 Gy each over a 3-week period. Neurologic function rapidly improved to full ambulation with only minimal monoparesis of the right pelvic limb. Results of neurologic and MRI examination performed 26 months after surgery indicated no change in neurologic status or evidence of recurrence. CLINICAL RELEVANCE To the authors' knowledge, this report was the first to describe the long-term outcome for vertebral angiomatosis in a cat. Surgical decompression and radiation therapy provided an excellent outcome in this case. Vertebral angiomatosis should be considered as a differential diagnosis for any young cat with thoracolumbar myelopathy secondary to a mass associated with the vertebral pedicle.